Friday, June 21, 2013

National Alzheimer’s Project Act: Expectations of Care for Residents With Alzheimer’s Disease

            Nearly half (48%) of nursing home residents have Alzheimer’s disease.1  In more than 90 percent of people with Alzheimer’s disease, symptoms do not appear until after age 60 and the incidence of the disease increases with age.2  Skilled nursing home facilities are expected to provide care for residents who are battling this disease and meet the individualized standards of the families of the residents.
On January 4, 2011, the Department of Health and Human Services established the National Alzheimer’s Project Act.  NAPA is a national plan implemented to overcome Alzheimer’s disease, coordinate research, accelerate treatments that would prevent, halt, or reverse the course of Alzheimer’s disease, improve early diagnosis and treatment, improve outcomes for minority populations that are also at higher risk for the disease, and coordinate with international bodies to fight Alzheimer’s globally.3  The Obama Administration announced on February 7, 2012, a $156 million investment to tackle Alzheimer’s disease, which will be used to sustain research and support individuals and families affected by the disease.
Goal 2 of NAPA, to “Enhance Care Quality and Efficiency”, directly influences the expectations of nursing home facilities.  Action 2.A.4, to “Strengthen the direct care workforce”, was completed this year.  HHS strengthened the ability of nursing home direct care workforce to provide high-quality, person-centered care for people with AD through enhanced training.4  A series of videos, “Hand in Hand,” were developed and distributed to every nursing home in the country.5  The Center for Medicare & Medicaid Services created the videos to ensure nursing aides and other care staff receive regular training on the care of persons with dementia and to emphasize person-centered care for these residents.6
Goal 3 of NAPA is to “Expand Supports for People with Alzheimer’s Disease and Their Families.”7 The Department of Health and Services recognizes that AD strains families emotionally and physically. The intensive support required for a person with AD can negatively impact a caregiver’s well-being.  Action 3.B.2, to “Identify and disseminate best practices for caregiver assessment and referral through the long-term services and supports system”, was also completed this past year.8  The Administration on Aging partnered with the National Family Caregiver Alliance to create Selected Caregiver Assessment Measures (2nd Edition): A Resource Inventory for Practitioners. http://caregiver.org/caregiver/jsp/content/pdfs/SelCGAssmtMeas_ResInv_FINAL_12.10.12.pdf. The manual identifies caregiver assessments, perceived challenges for caregivers of certain persons, expected skills and knowledge of caregivers of persons with Alzheimer’s Disease, and resources for caregiver’s to use, including nursing home support as well as the stressors of nursing homes.9
As the number of people with Alzheimer’s Disease grows over the next two decades, this disease will place a major strain on health care facilities as well as on Medicare and Medicaid, the major funders of this care.  Holding nursing home care facilities to the standards laid out in NAPA is significant.  NAPA provides the guidelines skilled nursing facilities are expected to follow and may inform your decision when choosing a home for your loved one.


1. Magaziner J, German P, Zimmerman SI, Hebel JR, Burton L, Gruber-Baldini AL, May C, Kittner
S. The prevalence of dementia in a statewide sample of new nursing home admissions aged 65 and older. Gerontol. 2000; 43(4): 514-520.
2. National Plan to Address Alzheimer’s Disease: 2013 Update, page 7
3. Id. at 8
4. Id. at 18
6. NAPA at 18
7. Id. at 27
8. Id at 28
9. Selected Caregiver Assessment Measures: A resource Inventory for Practitioners: December 2012, Index 


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